A few years ago I worked at a hospital as a constant observer.  It was a transitional job as I tried to figure out the next step of my life. What exactly is a constant observer?  one might reasonably ask.  A constant observer is basically a nurse’s aide who stays in one room to be with patients who might be a harm to themselves or others. Hospitals try very hard not to tie people down on their beds anymore.  There are a lot of reasons I might be assigned to a patient: dementia, adverse reaction to medication, brain injury, detoxing, or suicide watch, to name some.  I saw people at their most vulnerable state.  This is the third in what I plan to be a series of vignettes on my experiences in the hospital.

The moment I step into the room she’s in the middle of packing to leave. She’s already kicked her sister out that morning (after calling 911 twice). Her therapies for the day have been canceled. I convince her to take a walk with me around the unit, but when she gets back to the room she keeps packing. It’s not going to be an easy day.

She carries her bag out to the hall and looks for the exit in another patient room. She sets her bag down because it’s heavy with her hair products, magazines, and clothes. Her nurse manages to take her on another walk around the unit while holding her hand. Her nurse is very good with her and has a calming influence (and medication). When she comes back she takes a nap for a half hour (like I said, medication). When she wakes up she’s fairly calm and normal again for half an hour or so. Then she realizes her washer/dryer aren’t there, so they must have been stolen. Obviously I am involved in their disappearance.

The day before she had blown up at me when she couldn’t find her appointment book. I had tried to explain that her sister was holding on to it while she was in the hospital and had called many of her clients to let them know of the situation. She was in the hospital because of a brain aneurysm. She accused her sister of trying to ruin her business, and then she said I had taken her sister’s side and that I should just stay out of her family business. She had trusted me, and she thought I was couth. The nurse was able to calm her down, and later in the day I came back in the room and she had totally forgotten the incident.

Whenever she wasn’t mad at me, she treated me like a confidante. She would complain to me and talk bad about anyone after they left the room. While the nurse or aide was in the room, she would act relatively nice and compliant, but as soon as they left the room she would launch into them. Everyone was bitchy, or would cut your throat, or was snotty. I wondered what she said about me when I wasn’t in the room.

Later that day, right before I was off for the night, she looked for her cigarettes. I tried to explain that she didn’t have any because there was no smoking allowed in the hospital, but she said they had been in the drawer and now they weren’t so I must have stolen them and thrown them away. She walked out of her room and then right back in, but when she came back she wouldn’t look at me. She faced the other direction, towards her bed and the window, with her arms crossed. The night shift came in while this was going on. I slunk out of the room, escaping her silent accusations.

So now we’re back together again, and she’s upset about the missing washer and dryer. She goes to the bathroom, and when I ask if she’s okay in there (she could be unsteady at times) she comments that she can’t even go to the bathroom without a guard. Then she storms out in the hall and one of the aides asks where she’s going. The aide offers to show her the washing machine on the unit. This doesn’t satisfy her She wants hers, so she’d rather leave the hospital.

The aide turns off the WanderGuard alarm as we leave the unit (the woman had on a tracking anklet since a previous escape attempt). We try to direct her back around to the unit, but instead the woman bolts right towards the elevators. She hits the down button but then looks towards the windows at the winter landscape (a feint, I later realize). The aide goes back to get help. I stay, hoping I can delay her from getting any farther, but then the elevator door opens. I don’t want her to get to it in time, but she reaches a hand in just before it closes. I try to steady her/restrain her, but she shrugs me off and then glares at me because I was touching her. She tells me not to do it again. She’s seething with fury at me.

Once in the elevator she hits the ground floor button, and I keep hitting the open door button. It starts beeping loudly, so I let it go. We travel down, and I worry how I am going to stop her from going out the front door. It’s zero degrees outside with a wind chill even lower. I’m in a near panic about what to do. When we get to the ground floor she tells me she’ll yell if I touch her. I keep thinking about how to delay her or call security. I somehow manage to divert her to the information desk. She wants to complain about her treatment, but she has to wait because there is someone ahead of her. Then she sees her niece’s boyfriend and I see the niece and I motion almost frantically for her to come over. I’m so relieved that she happens to be there at that moment. She talks to her aunt, soothing her, and leads her back to the elevator.

Back on the unit, her nurse talks to her as well. I stay away for an hour. I sit in the nurses’ station and try to soothe my nerves. I’m tense and almost shaking. I go back to her room as her dinner arrives. She’s completely forgotten the incident and isn’t mad at me or anything. She falls asleep soon after dinner and sleeps nearly the whole night through. I find out later she does get up in the night for 40 minutes or so and apparently thinks the sink in her room is an oven and tries to light the gas burner.

Coda: The next day we watch a marathon of “What Not to Wear” on TLC together.